Individual provider Active NPI

Mindy Ann Hamrick

  • Physical Therapy Assistant
  • Gallatin, TN
National Provider Identifier
1689386229
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA0000004878 Issued in TN
Practice address
555 E Bledsoe St
Gallatin, TN 37066-3003
Phone
(615) 452-7132
NPI assigned
Dec 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA0000004878 TN Primary

Addresses

Primary practice location

555 E Bledsoe St
Gallatin, TN 37066-3003

Mailing address

150 Ferdinand Dr
Gallatin, TN 37066-1596
Phone (865) 235-5267

Other identifiers 1

IdentifierTypeStateIssuer
PTA0000004878MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL optima Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA0000004878TNMDPhysical Therapy Assistant

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1670976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1689386229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 FERDINAND DR",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370661596",
            "telephone_number": "865-235-5267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E BLEDSOE ST",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370663003",
            "telephone_number": "615-452-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMRICK",
        "first_name": "MINDY",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-14",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "PTA0000004878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PTA0000004878",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "optima",
            "affiliation": "N",
            "endpointDescription": "Laptop",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "555 E Bledsoe St",
            "city": "Gallatin",
            "state": "TN",
            "country_code": "US",
            "postal_code": "370663003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.